Public access AED success in Japan

AEDs are automatic external defibrillators which give instructions to the lay operators and can be used by the lay public for resuscitating a person in cardiac arrest. AEDs are kept in public places where large number of people arrive as in airports. Japan is a country with nation wide access to AEDs. A recent study published in the New England Journal of Medicine [Kitamura Tet al, NEJM 362:994-1004] evaluated the benefit of these devices in Japan. They included 312,319 adults who had an out of hospital cardiac arrest over a period of two years in this study. Of these, 12,631 had ventricular fibrillation and a witnessed cardiac arrest due to cardiac cause. Four hundred and sixty two of them received AED shocks administered by lay persons. While 14.4% of those with a witnessed cardiac arrest due to ventricular fibrillation was alive at one month with minimal neurological deficit, 31.6% of those who received AED shocks had a similar status. All those who received early defibrillation regardless of whether it was administered by a paramedic or a bystander, there was good neurologic outcome. The figures improved as the number of public access AEDs increased from 1 per square kilometer of inhabited area to 4 or more.